THE HONG KONG COLLEGE OF OBSTETRICIANS AND GYNAECOLOGISTS Re-certification of Reproductive Medicine Subspecialists Applicant : _______________________________________________ Period Covered: ___________________ to ______________________ Re-certification of RM Subspecialists July 2005 Published by: Reproductive Medicine Subspecialty Board The Hong Kong College of Obstetricians and Gynaecologists Room 805, Hong Kong Academy of Medicine Jockey Club Building 99 Wong Chuk Hang Road Aberdeen Hong Kong Tel: (852) 2871 8700 Fax: (852) 2896 4902 Email: admin@hkcog.org.hk The Hong Kong College of Obstetricians and Gynaecologists is a Constituent College of Hong Kong Academy of Medicine Re-certification of RM Subspecialists July 2005 Guidelines for Re-certification of Subspecialist in Reproductive Medicine, HKCOG A reproductive medicine subspecialist who satisfies the audit activities and the continuous medical education requirements may apply to the Board for recertification. There will be 2 submissions of audit and CME activities, the first one soon after the first 3 years and the second one 6 months before completion of the 6year cycle. Each submission should include:i. the total number of clinical workload in the 3-year or 2½ year period as appropriate ii. detailed logged work in any self-selected consecutive 6 month period iii. CME activities in the 3-year or 2½ year period as appropriate AUDIT ACTIVITIES 1) A statistical summary of the patients managed over the past 3-year (or 2½ year period as appropriate) should be provided in RM-I. This included :a. The total number of patients with reproductive endocrine disorders or subfertility managed by you during the audit period. b. The total number of reproductive treatment procedures performed by you as principal physician or as supervising physician during the audit period. 2) Logging of 6 continuous months of reproductive treatment procedures performed by you over the past 3-year (or 2½ year period as appropriate) should be provided in RM-II. The information on operative procedures (including reproductive surgery, oocyte retrieval, embryo transfer, gamete/zygote tubal transfer) must be certified by the unit head or hospital superintendent/hospital chief executive. Each case or procedure should be submitted only by one applicant whose name is among the list of operators in the operation record. If there are more than one operator in the list of operators, the operators should resolve among themselves which operator can submit the case. 3) An annual minimum of 100 cases of reproductive endocrine disorders or infertility, and 20 treatment cycles of IVF and/or GIFT/ZIFT is expected to be managed by a reproductive medicine subspecialist. CONTINUOUS MEDICAL EDUCATION 1) CME activities related to reproductive medicine – (a) research (b) teaching (c) attending conferences related to reproductive medicine Re-certification of RM Subspecialists July 2005 2) A minimum of 90 CME points including at least 60 reproductive medicine CME points is required in every 3-year cycle. The method of calculating CME points is similar to the current CME system for general O&G. Information on CME activities over the preceding 3 years or 2½ year period as appropriate should be provided in RM-III. The College reserves the right to accept or reject the subspecialty CME points claimed. Please note: 1 Regulations governing the re-certification are located in the Subspecialty Training and Development Documents in Reproductive Medicine issued by the College. 2 The Subspecialty Board reserves the right to ask for additional/detailed evidence in support of the claims by the applicants. Please contact Reproductive Medicine Subspecialty Board if your have any queries. Re-certification of RM Subspecialists July 2005 Application for Re-certification of Reproductive Medicine Subspecialist, HKCOG I would like to apply for re-certification of subspecialist in reproductive medicine. (For the period from ____________________ to ____________________ ) I Personal data Name (surname first) HKID/Passport No. Sex Date of birth Correspondence address Phone II Fax E-mail Medical education and training Medical school Basic degree Member of HKCOG Qualifications: Year Year MRCOG Year FHKAM(O&G) Year MRACOG FRCOG Year FHKCOG Year FRACOG Others III Subspecialist in Reproductive Medicine (HKCOG) since: IV Type of practice: HA / University / Private (delete as appropriate) Re-certification of RM Subspecialists July 2005 (MM/YY) RM-I V. VI. Total number of new patients with reproductive endocrine disorders or subfertility managed by you over the *past 3 or 2½ years Reproductive endocrine disorders ___________ Subfertility ___________ Others (specify) ___________ Total number of the following reproductive treatment procedures performed by you over the *past 3 or 2½ years a Reproductive hormone therapies ___________ b Reproductive surgeries ___________ Superovulation for IUI/IVF/GIFT (inclusive of ovarian monitoring) ___________ Intrauterine insemination ___________ Oocyte retrieval ___________ Embryo transfer ___________ Gamete / embryo tubal transfer ___________ Others (specify) ___________ * Circle as appropriate a Reproductive hormone therapies include bromocriptine or other drugs for hyperprolactinaemia; clomiphene, metformin or other oral drugs for induction of ovulation; hormonal treatment for endometriosis; hormonal treatment for polycystic ovarian disease; hormonal replacement therapy and other pre-recognized hormonal therapies. b Reproductive Surgical Procedures include therapeutic surgery for pelvic endometriosis; adhesiolysis; ovarian drilling; tubal recannulation; salpingostomy /salpingectomy for hydrosalpinx; tubal reconstructive surgery; operative hysteroscopy; myomectomy and other pre-recognized therapeutic reproductive surgical procedures. Name of Applicant Date: Re-certification of RM Subspecialists July 2005 Signature of Applicant RM - II Application for Re-certification of Reproductive Medicine Subspecialist, HKCOG Logging of 6 continuous months of reproductive treatment procedures performed during the audit period Period of detailed logged work: from____/___/____ to Date Hosp. No / * ID No Diagnosis _____/____/____ Treatment Outcome (if any) * Include character and first 5 digits of ID. No. only Name and Signature of Applicant Date: Re-certification of RM Subspecialists July 2005 Name & Signature: Certification Unit Head/Hospital administrator Page ____ of RM-II RM - III Reproductive medicine related CME activities in the *past 3 or 2½ years (based on CME programme approved by the HKCOG) Period of time: from____/___/____ to _____/____/____ * Circle as appropriate Activities #Subspecialty CME points in Reproductive Medicine Category 1 meeting 1a Meeting - Active 1b Meeting - Passive Category 2 meeting 2a Meeting - Active 2b Meeting - Passive Category 3 meeting 3a Meeting - Active 3b Meeting - Passive Publications Self Study Quality assurance Others (Please specify): # You may be required to provide proof of the Subspecialty CME points claimed Name of Applicant Date: Re-certification of RM Subspecialists July 2005 Signature of Applicant Page ____ of RM-III